— Readers seemed to be convinced of the benefit of vitamin D and calcium supplements, according to results of a MedPage Today poll.

Readers seemed to be convinced of the benefit of vitamin D and calcium supplements despite conflicting evidence about their efficacy, according to results of a MedPage Today poll.

Earlier this month, the U.S. Preventive Services Task Force issued a draft recommendation stating that low doses of these supplements do not offer a fracture benefit for older women. But a meta-analysis also published in June found a small mortality benefit for those taking both supplements.

Although 55% of the 1,686 people who voted in our poll indicated they would tell patients to take both supplements, nearly 30% suggested there is no need for vitamin or mineral supplements if patients eat a balanced diet.

One reader commented that along with lots of calcium-rich foods, people should take small doses of calcium supplements accompanied by a daily supplement of D3 1000 IU. The "take-away message," she said, is "no unopposed calcium."

The problem with trying to eat vitamin- and mineral-rich foods, according to reader comments, is that by the time they are on the dining room table, they've lost all of their nutritional value. So supplements are necessary. But calcium is "only absorbed in an acidic environment" and the "best forms are lactate or citrate," said one commenter, who added that vitamin D should be D3, not D2, which many readers echoed.

However, if you raise your own hens and eat their "nutrient-filled eggs," as one nurse wrote, your vitamin D should be fine. This 54-year-old woman just had her first serum vitamin D level done and it was 50 ng/mL -- and she does not take supplements.

A big problem today, readers suggested, is that many patients are in fact vitamin D deficient, clocking in at less than 30 ng/mL.

Of course, there is the problem of modern society working under the influence of artificial lighting, which does not allow the sufficient intake of vitamin D, coupled with the fear of exposing oneself to direct sunlight.

And several readers reminded us of the importance of vitamin K, especially for menopausal women. Some suggested that the poor results in studies of calcium supplementation could be related to low levels of vitamin K that weren't accounted for.

Others suggested that the levels of vitamin D in studies (400 IUs) are "the equivalent of about 24 seconds of sun in your swimming suit at a Los Angeles beach in the summer. No wonder there is no benefit. This is sort of like saying that doing three curls with a one-pound dumbbell won't increase the size of my bicep."

There were many comments with varied recommendations for vitamin and mineral supplementation, which perhaps indicate the challenge to physicians. Sometimes patients need supplementation, but which is the best and how does the patient's other dietary habits potentially interact or interfere with the supplements' benefits?

In the long run, most physicians might feel that recommending these supplements pose no threat. And there were comments that were critical about relying on meta-analyses to make decisions on vitamin D and calcium supplements.

Of course, it can't hurt to be tested for vitamin D deficiency, some readers suggested. And then to work with your doctor on maintaining healthy levels of this most important nutrient.

The last word comes from a doctor who brought up the vitamin E "craze" that included giving vitamin E to "premature infants and everyone that had heart disease." He added that "now the only patients I see taking vitamin E are the ones that are on 20 other supplements. Health comes from the luck of good genetics, making good choices, and a healthy lifestyle, not a pill."

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